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Home My WebLink AboutEHPR-12-09-2994.TIF A CMG THIS IS NOT A PERMIT Case # EHPR-12-09-2994 CATAWBA COUNTY HEALTH DEPARTMENT Plan Review Application for Environmental Services 1842 SM, Environmental Health Plan Review - Septic Malfunction EP_MALFUN APPLICANT OWNER CONTRACTOR MAGDALENE RUELAS MAGDALENE RUELAS 2355 S NC 16 HWY 2355 S NC 16 HWY NEWTON NC 28658 NEWTON NC 28658 NAME TO APPEAR ON PERMIT MAGDALENE RUELAS Pin#: 365914344798 SITE ADDRESS: 2355 S NC 16 HWY, Newton, NC DIRECTIONS: HWY 16 S, 3RD HOUSE PAST CRESTVIEW DR ON RIGHT, ACROSS FROM DAY CARE CENTER NAME of SUBDIVISION: LUTHER SIGMON PROP Lot # 5-7&PT8& Section/Block/Phase PROPERTY SIZE: Square Feet Acres 0.529 Date Platted/Recorded TYPE OF FACILITY: House X Mobile Home Dimension of Structure Bedrooms 3 Basement: Yes Water Using Fixtures in Basement:Yes No. in Family 4 Whirlpool Tub : Gal. Capacity: MULTIPLE FAMILY RESIDENCE: Units 1.00 Total Number of Bedrooms DAYCARE: Number of Children RESTAURANT: Seats Square Feet Dining Area Square Feet Foodstand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees Ist 2nd 3rd OTHER: (Specify) Do you aniticipate any additions to Facility? If so, describe: NO Has any grading, removal, or addition of soil been done to this property? If so, describe NO Are there easements/right-of-ways recorded on this property? NO Type of Water Supply: Individual Well X Community Well Municipal Semi-Public I understand that this is a formal application for a well permit, Improvement permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is transferable and may be eligible for a non-expiring date, but may be revoked if this information, site plans or intended use changes for the proposed facility. A Well Permit and Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this property. Any representation by you of house or structure location should conform to applicable setbacks. / n Date: l e103 100 Signature of Applicant or Agent ll ye elew a An Environmental Health Specialist will contact you within 2 working days of application date. If you need further information or assistance please call 828-466-7291 AREA 1 (FOR OFFICE USE ONLY) Zoning Approval: _Yes No Zoning Approval UDO Zoning Form A Minimum Setbacks Front FEE NAME DATE AMOUNT Side Authorization to Construct (Repair) Fi12/03/2009 $300.00 Rear TOTAL FEES $300.00 Max Hght *If a permit has to be redesigned and / or RETRIPS made to the property, there is an additional $60 charge 12/03/09 16:17 THIS IS NOT A PERMIT WLS # CATAWBA COUNTY HEALTH DEPARTMENT Application for Environmental Services Improvement Permit ❑ Authorization to Construct ❑ Septic Repair LZ Septic Expansion ❑ Existing Tank Check ❑ New Well Permit ❑ Replacement Well ❑ Well Abandonment ❑ I. Name to Appear on Permit <lencl Lc.Icgz 2. Permit Requested By Hn.. IC1r~Pr,Rt ► e let's Business Phone Address uz) V 1 b Nc~'~:'G N C 23GS2 Home Phone 3. Property Owner Business Phone Address 7 ZS~; k k {Vt?iai+C~ 1 (\d C 7. Home Phone c G- ~ I 4. Name of Subdivision Lot # Section/Block/Phase Property Address Directions to Property: u l 16 4i),4j, 5. Property Size: Square Feet Acres Date Platted/Recorded 6. TYPE OF FACILITY: House Mobile Home Dimension of Structure Bedrooms* 3 *Any room that will be intended for sleeping at the time of construction or for future consideration should be noted as a bedroom and counted on all applications. The number of bedroomswill be confirmed by rooms identified on honsc plans asa bedroom at the time of building permit issuance. This may,prcvent the need for system size increase in the future. Basement: es no Water Using Fixtures in Basement: es no No. in Family Whirlpool Tub yes/no Gallon Capacity MULTIPLE FAMILY RESIDENCES: Units Total Number of Bedrooms DAY CARE: Number of Children RESTAURANT: Seats Square Feet Dining Area -Square Feet Food stand/Meat Market Floor Space TYPE OF BUSINESS: Number of Employees 1 st 2nd 3rd OTHER: (Specify) 7. Do you anticipate any additions to Facility? Yes If so, describe: 8. Has any grading, removal, or addition of soil been done to this property? Yes No If so, describe: 9. Are there easements/right-of-ways recorded on this property? Yes k~d 10. Is a public water supply available on or adjacent to the above property? Yes / No Check type that is available: [ ] Community well [ ] Semi-public well [ ] County/City/Township water line **If No, a Well Permit must be issued with the Septic Permit.** 11. Well Type Applying For: [ ] Individual well [ ] Community well [ ] Semi-Public well I understand that this is a formal application for a well permit, Improvement Permit or Authorization to Construct a ground absorption sewage disposal system to serve the above described facility on this property and authorize Catawba County Health Department employees to go on this property for evaluation purposes. I certify the above information to be correct and understand that an Improvement Permit issued as a result of this information is valid for 5 years or may be non-expiring under certain specified conditions. Improvement Permits and Well Permits are transferable, but may be revoked if this information, site plans or intended use changes for the proposed facility. An Authorization to Construct issued by this department is valid for (5) five years from the date issued and is not transferable. Note: You must obtain Zoning Approval prior to locating a home or structure on this property. Any representation by you of house or structure location should conform to applicable setbacks. **IF A PERMIT HAS TO BE REDESIGNED AND/OR RETRIPS MADE TO THE PROPERTY, THERE IS AN ADDITIONAL CHARGE." Date Signature of Owner or Agent ( ► eICt's Catawba County, North Carolina This map product was prepared from the Catawba County, NC, Geographic Information 5vstem. N Catawba County has made substantial efforts to ensure the accuracy oflocation and labeling information contained on this map. Catawba Co my promotes and recommends the independent verification ofony data contained on this map product by the user. 77ne County of Catawba, its employees, agents and personnel disclaim, and shall not be held liable for any and all damages, loss or liability, whether direct, indirect or consequential which arises or may arise from this map product at, the use thereof by any person or entity. Legend Selected Parcel Number: 3659-14-34-4798 1 inch = 40 feet Prepared for: % r l f 9p i 22 1.03A'\\,\ 100.00 3t (35 !1 it Plat 9 12 Z y11 cv ~ r l z i 10 4798v 8 N ° ,1 6 l 5. 0,786 I \ 29 3 N ~2 30 -,33 THIS IS NOT A LEGAL DOCUMENT Thursday, December 03, 2009 04:06 PM CATAWBA COUNTY NC - Parcel Report Information Regarding Selected Parcel(s) Parcel ID: 3659-14-34-4798 Name: CHAVARIN MAGDALENE RUELAS Name2: Address: 2355 S NC 16 HWY Address2: City: NEWTON State: NC Zip: 28658-8936 Account: 159366000 Calc Acreage: 0.53 Tax Map: 040N 01020B LRK: 28645 Deed Book: 2874 Deed Page: 1732 Subdivision Name: LUTHER SIGMON PROP Subdivision Block:2 Lots: 5-7&PT8&30 Plat Book: 9 Plat Page: 107 Building Number: 2355 Street Name: S NC 16 HWY Site Zip: 28658 Township: NEWTON Fire Code: NEWTON RURAL City Code: COUNTY State Road: Total Bldgs Value: $75,600 Land Value: $10,500 Total Value: $86,100 Year Built: 1958 Year Remodeled: 2007 Last Sale Date: 11/6/2007 Last Sale Amount: $94,000 Neighborhood: 117 Watershed: Watershed Split: Voter Precinct: P32 E911 District: COUNTY Zoning: R-40 Zoning2: Zoning3: Zoning Split: N Zoning Overlay: RP-0 Zoning District: COUNTY Split Zoning Dist: N Split Zoning Dist(1): 0 Split Zoning Dist(2): 0 School District: COUNTY Elementary School: BALLS CREEK Middle School: MILL CREEK High School: BANDYS School Split: NO P&Z Case Number: Census Tract 2010: 011600 Census Block 2010: 1021 Small Area Plan: BALLS CREEK Agricultural District: PROXIMITY Printed: Thursday, December 03, 2009 04:06 PM CATA"A COUNTY, NC 100-A South West Blvd PLAN RECEIPT C Newton, NC 28658- 0 (828)465-8399 Thursday, December 3, 2009 84 Z sM www.catawbacountync.gov Plan Case: EHPR-12-09-2994 Invoice Number: INV-12-09-257737 Environmental Health Plan Review Invoice Date: 12/03/2009 Fee Name Fee Amount Authorization to Construct (Repair) Fee Adjustable $300.00 Total Fees Due: $300.00 PAYMENTS Date Pay Type Check Number Amount Paid Change 12/03/2009 Cash -1 $300.00 $0.00 Total Paid: $300.00 Total Due: $0.00 pl;n rccei0i ; ~~i121"J-e2h8-ladh-<~12n-uUtd%.;'_ I cc~9; rrt 12/03/2009 16:16